So much of the conversation about pre-exposure prophylaxis (PrEP) has been reduced to labeling the people taking PrEP (“Truvada whore,” and more) instead of listening to them. Queerty wanted to get past those labels, so we spoke to five gay men on PrEP about why they chose to take a pill to prevent HIV infection — and their thoughts on the debate about it and the changes in their sexual lives that it inspired.

“My likelihood of having a sex partner who is positive, knowingly or unknowingly, is astronomical,” Blake told us, pointing out that young gay black men account for much of the increase in new HIV infections. Studies indicate that, although black men are more likely to use condoms during sex, the high incidence infection among black men who have sex with black men means they are more likely to come into contact with the virus than white men.

“I had to confront realities about myself,” said Blake, who serves as chair of the Young Black Gay Men’s Leadership Initiative, “including my race, my age, my risks for HIV and how I like to have sex. Particularly if I want to keep having what I define as great, fully satisfying, roll-over-and-smoke-a-cigarette unencumbered sex.”

Blake chose PrEP two years ago because he was “exhausted” from the mental gymnastics of sero-sorting (having sex only with those who share your status), and adds that “even as a top, that’s not foolproof.”

“PrEP allows me to have the sex I want to have without the risk of contracting HIV. I can, with almost 100 percent assuredness, put behind me the fear of contracting HIV due to a casual hookup or a long term relationship gone sour.”

Blake has no interest in fanning the flames of the condom debate. “Condoms still work and if they work for you, get on with your life,” he said. “But PrEP is another option to prevent HIV, and it’s the one I choose.”

Damon Jacobs, 43

If you google PrEP and gay men, chances are you will end up with an article by Damon Jacobs, and probably a photo of him wearing a “Truvada Whore” or “PrEP Warrior” T-shirt — or less (see above). The New York City therapist embraces his role as one of the most visible PrEP advocates on the scene even if it means talking about his most intimate habits.

“I started PrEP in 2011 because I wanted to maximize pleasure,” Damon told us. “The experience has resulted in feeling more peace of mind and sexual confidence than before.”

Damon isn’t afraid to speak up about the importance of pleasurable sex for gay men and our right to have it. “Most of us are seeking ways to experience maximum pleasure with minimal risk,” he said. “If we ignore pleasure, we are doing our community a huge disservice. Why do we still have new HIV infections in 2015? Because fucking feels good.”

Just acknowledging that we want sex to feel great is something Damon believe can move us forward. “When we start from there,” he said, “then we can discuss ways that sex can also be healthy, responsible, and empowering.”

Mathew Rodriguez, 26

Mathew, a journalist from Queens, NY, has a very personal reason for doing everything he can to remain HIV negative. He lost his father to AIDS, which “affected my family deeply,” he told us.

Mathew has been on PrEP for the last year. He started because he was in a non-monogamous relationship with someone who began PrEP himself. When they broke up, Mathew continued using the drug.

Just don’t mention the whole “Truvada Whore” meme to Mathew, who isn’t having it. “I don’t identify with the term,” he said, “but I do wish gay men in general had more open conversations around pleasure and the ways we make love to each other.” He believe that PrEP has at least started a conversation about how gay men want to have sex and why.

“Fucking is fun. It is a tactile experience that carries spiritual, mental and emotional weight. I say it’s tactile because it’s skin on skin, plus fluids. PrEP has allowed people to return to cum as a meaningful part of sexuality, not an alien substance to be feared. PrEP has allowed me to have someone look into my eyes as he was on top of me, inside me, and for us to connect in a way that carried emotional, intergenerational weight. PrEP has meant that I don’t have to live what I’ve called ‘the life of the gay statistician.’ What’s the chance that the semen permeated the skin of the condom? What’s the chance I contracted something? What’s the chance that my cough is seroconversion flu?”

Tom Butcher, 53

Starting PrEP just one ago, Tom was initially nervous about the drug and reached out to online PrEP groups for information and support. After a few days of side effects (“I was dizzy and kind of foggy,” he told us), Tom feels fine and is headed for a follow-up visit this week.

“I came out in 1984 and lived through the very darkest days of the epidemic,” Tom said. “It scarred my soul.” His trauma from those early years also kept Tom from getting tested very often, something being on PrEP will change. Getting regular blood work to check for side effects, HIV and other STI’s is a part of being on the drug.

Tom works in New Haven, CT, as a project director for HIV support services, and his friend and colleagues have been completely supportive. He is aware of the personal criticisms that occur online, though, and he is braced for it.

“I am human,” Tom said. “I am a sexual being. I make mistakes in all other realms of my life. Now I am empowered to take control of my life and my health. My fear has been replaced by being empowered to take care of myself no matter what a lab test shows. With PrEP the likelihood of infection is drastically reduced.”

Ney Enrique, 36

Ney started using PrEP six months ago, and came to the prevention strategy by way of his art. The multi-media storyteller from Wilton Manors, FL, was producing a documentary abut PrEP and found the evidence so compelling that he started taking it himself.

“Of course, I studied up on it beyond the documentary,” Ney told us. What he found out has made Ney an outspoken fan. “I think everyone who is sexually active should be on it if they are not monogamous. It should be a global strategy but we, as PrEP users, have to advocate for it.”

The fact that doctors themselves are often not educated about PrEP frustrates Ney. “Medical providers are the first ones to ignore what PrEP is about,” he said, “so it is logical that patients don’t know about it or they feel afraid about it.”

Ney adds that, while some gay men he knows are curious to find out more about PrEP, “others put us under the same HIV stigma umbrella,” as if being on PrEP makes him more of a risk to them instead of less.

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194 Comments

This quote right here: “The fact that doctors themselves are often not educated about PrEP frustrates Ney.” It IS frustrating…very.
I’m lucky I didn’t have that issue, but I admin a discussion page for gay men who are in open relationships–the perfect candidates for PrEP–and the number of them who report an uphill struggle to get prescriptions for it just infuriates me at times. Doctors need to catch up.

May 9, 2015 at 10:05am

theszak

The Strategy. BEFORE sex get tested TOGETHER for A VARIETY OF STIs then make an INFORMED decision, google… tested together before

May 9, 2015 at 10:05am

gaypalmsprings

Great article, Mark. Sexy has nothing to do with PrEP, though. I have been on PrEP for 11 months and the anxiety I have had about getting HIV through sex has been reduced by 100%. At 60 years of age, my options have expanded, and I thank Damon Jacobs for his inspiration.

Prinny

It would be absolutely hilarious if all 5 of them got HIV.Truvada isn’t 100% safe and doesn’t protect from other strain of HIV or STIs.People would think we learned our lesson before but nope still the same idiots.

May 9, 2015 at 10:05am

courthousedoc

Other strain of HIV? Really? Want to share which one that is? And Truvada is far more effective than condoms alone or did you know that? And the protocol for PrEP is to be tested for HIV and ALL STIs every 3-6 months so that if you do get an STI you can get treated for it quickly and easily. How often are you tested? And the most common STIs are just as easily transmitted via oral sex. Or do you have oral sex with a condom. Because if you do, you are that rare unicorn. You’ve been brainwashed into believing that condoms only are the only way to have safe sex. This isn’t the 1980s. And science actually does exist.

May 9, 2015 at 11:05am

Taskebab

Good, they don’t get HIV…but they will get chlamydia, gonorrhoea, hepatitus, herpes, genital warts, syphilis and everything else…why start using a pretty aggressive and risky drug that only prevents ONE std when you can just slip on a condom that prevents most std’s?

May 9, 2015 at 11:05am

Taskebab

Also I want to know how much these guys get paid by the pharmaceutical company that makes Prep to promote their product this way…

Thank you for running this piece; it’s mature and thoughtful. Basically what these 5 men are being is a role model for other men who are thinking about doing this. The “Truvada Whore” thing is old-school queer when we couldn’t do anything without injecting some dose of irony (or some people might say “self-hatred”) into it. You’re not being a Truvada Whore when you use PrEP—you are simply pushing the odds to be more in your favor, and life now with all of its economic and emotional stresses needs that. Even if you are using PrEP you still need to be smart about it, use sense and caution, and realize how far you can go. Perry Brass, author of The Manly Pursuit of Desire and Love, new at Amazon.

May 9, 2015 at 11:05am

onthemark

Eek, some bad gay guys are having sex.

I hope some good boys show up here to brag about how much better they are than these awful sluts. Yes, we always need THAT message!

@Prinny: It would be absolutely hilarious if you got run over by a garbage truck. Afterwards tossed in and squashed.

May 9, 2015 at 11:05am

lauraspencer

Not sure why this title has to work “sexy” into the issue. If sexy guys are using Prep then the rest of us should to?

Several comments from the above interviews concern me….

“Fucking is fun. It is a tactile experience…”

“…and how I like to have sex.”

” I wanted to maximize pleasure,”

These guys are all basically saying they like to bareback. With the “success” rates of Prep highly questionable the best prevention is to use a condom. Do not rely on Prep to protect you.

We have also heard about side effects from Prep and I have seen them first hand. I have a friend who has been on Prep for 8 months and the change in his skin and face is obvious from the medicine. Remember Prep is developed from HIV meds and it is hard on your system.

Wear condoms.

May 9, 2015 at 11:05am

Cam

I’m sorry, but all of this manufactured outrage over something that the gay community has said it has wanted for decades “Something to prevent infection” just smacks of the Old Guard not wanting to lose their livelyhoods, or being unable to change with the times.

If anybody has ever seen the movie “And the Band Played On” about the early years of the AIDS crisis, look at how the bathouse owners responded to the suggestion that people use condoms, it is eerily similar to the way people are responding to the suggestion that people take these pills.

Sorry, but when HRC was telling the community to sit down, shut up and not ask Democrats to support us, Get Equal popped up, and HRC became irrelevant in the fight against Don’t Ask Don’t Tell, and marriage until after most of the victories convinced them to jump on the bandwagon and now claim that they were there all along.

Same with Truvada, if there is something out there that would help, the Old Guard would do well to consider actually moving with the times instead of doing what they always do.

May 9, 2015 at 11:05am

Bromancer7

@Prinny: You know what would be REALLY funny? Watching you get hit by a crosstown bus. Now THAT would be HILARIOUS!

@Taskebab: It is still possible to contract all of those STIs even with condom use, especially herpes, hepatitis, and warts. And unless you’re also wearing a condom while getting a blow job you are totally at risk for syphilis, gonorrhea, and chlamydia as they can all live in the throat and be easily passed. Considering the last three as well as hepatitis are easily treated, upwards of 80% of sexually-active adults already have HPV and warts can easily be removed, the only one that’s really a concern is herpes — which again, condoms are not particularly effective at preventing. The belief that condoms will completely protect you from every STI on the planet is a myth.

Just as an aside, something I rarely see mentioned in PrEP articles are the potential long-term side effects. I was on PrEP for about 6 months and during one of my routine checkups (every 3 months) an abnormal protein level was found in my urine, meaning the drug was starting to affect my kidneys, and I had to stop taking it (it’s a known side-effect). While I enjoyed the freedom and peace of mind Truvada offers, it’s not worth going into kidney failure especially since my risk of contracting HIV is fairly low to begin with.

Don’t get me wrong, I’m still very much pro-Truvada, but if you’re going to take it make sure you keep up with the routine tests every 3 months. You don’t want to find out a year or two later that your kidneys are shot because of it. Mind you I had NO symptoms at all, and because it was discovered very early I’m told it should clear itself up fairly quickly with no permanent damage.

May 9, 2015 at 11:05am

Joe Dalmas

It is absolutely amazing to me that people would choose to go on a life-long treatment with significant side effects for a disease they do not have just so they can bareback with others who have the disease.

May 9, 2015 at 12:05pm

Prinny

@courthousedoc: Drug resistant strains of HIV.Truvada is useless against them.

May 9, 2015 at 12:05pm

Prinny

Bromancer7

@lauraspencer: I’m not sure what you’re getting at. Of course bareback sex is better than with a condom, that’s the whole point. The success rate of Truvada is not questionable, it’s been proven in multiple large scale studies to be at least as effective as condoms, if not more. And I’m sorry, but Truvada does not have “changes to the facial skin” as one of its side effects, so I’m guessing you just pulled that one out of your ass as usual.

If condoms work great for you, then by all means use them. They do not work great for everyone, and having other options is a good thing, not a bad one.

It’s like all you stubborn “condom condom condom” people work for Trojan or something, because the it’s the same old broken record that’s full of half-truths and outright lies.

If condoms were the holy grail of HIV prevention then there should be no new HIV infections in the last 20 years. That clearly is not the case, so obviously they are NOT the answer for everyone.

It absolutely baffles me why people would fight against another PROVEN way to avoid HIV infection. Stupid people just being stupid I guess. I just can’t come up with any other explanation.

May 9, 2015 at 12:05pm

courthousedoc

@lauraspencer: The success rate of PrEP is hardly questionable. Every study shows its success. Every study shows it is more effective at preventing HIV than condoms when taken every day. That is proven. We’ve relied solely on condoms for 30 years and there are still 50,000 new cases a year. How’s that working for you? Want to keep doing the same thing? Making the same arguments, getting the same results? That’s the definition of stupidity — doing the same thing over and over and expecting different results. Condoms were designed for vaginal sex, not anal sex. And even in vaginal sex, they are not 100% effective, even when used properly. That goes down significantly in anal sex. It was better than nothing, but it wasn’t a guarantee. Neither is PrEP, but PrEP, when taken as directed, is much closer to that than condoms. And THAT is a fact.

May 9, 2015 at 12:05pm

Bromancer7

@Joe Dalmas: What’s absolutely amazing to me is that’s what you take away from this discussion. Close-minded idiot.

May 9, 2015 at 12:05pm

Bromancer7

@Prinny: Citation please. I have read nothing about there being certain strains of HIV that are resistant to Truvada.

And yes, I’d gladly drive that bus.

May 9, 2015 at 12:05pm

courthousedoc

@Joe Dalmas: Who said it will be life-long? Do you know what tomorrow will hold? Do you know if a new drug will come along that will be even better for PrEP? Do you know if a vaccine will be invented? Do you know if a cure will come along for HIV? As the wise Yogi Berra once observed: “Predictions are hard to make, especially about the future”. Three years ago, PrEP wasn’t even available. Science isn’t standing still. And Truvada isn’t the last advance in the treatment and prevention of HIV. So no, this isn’t life-long. And thinking of it that way is such static thinking.

May 9, 2015 at 12:05pm

OhHellNo

Two things I don’t see much about in PrEP are Truvada’s long-term possible side effects (I guess liver damage, hair loss, enlarged thyroids and lipodystrophy discussions aren’t sexy, but neither will you be once they take hold) and its astronomical cost (surely this isn’t covered by insurance if you don’t have HIV). And by the time it’s found out a few years down the road that it isn’t the foolproof prevention it’s purported to be (because Gilead is a pharmaceutical company, and whatever gets them the most money works for them, so they sure as hell won’t tell you) it will be far too late. After all, they said AZT was a sure thing too at first, didn’t they?

May 9, 2015 at 12:05pm

courthousedoc

@OhHellNo: Yes, insurance covers it. And the other stuff is why you have routine, every 3-6 month lab work done. And Truvada has been in use for over a decade now so this isn’t anything new.

May 9, 2015 at 12:05pm

OhHellNo

@Bromancer7: “If condoms were the holy grail of HIV prevention then there should be no new HIV infections in the last 20 years.” That sentence only makes sense in a world where they’re used every time, all the time. (Or in a Tea Party pamphlet, but they’d misspell at least three words in the sentence.)Holy grails only work if you drink from them.

May 9, 2015 at 12:05pm

Random

@Taskebab: All of the STIs you list can be contracted even if someone uses a condom 100% of the time during anal sex.

I do find it worrying that gay men are so poorly educated about their own sexual practices and health and appear to believe the myth that condom use protects them from all sexually transmitted infections. IT DOESN’T.

May 9, 2015 at 12:05pm

courthousedoc

@OhHellNo: You are assuming that condoms work 100% of the time if used properly — they don’t. They were designed for vaginal sex and they aren’t even 100% effective there. The manufacturers say so. The CDC says they fail 9% of the time at pregnancy prevention. And they have NEVER made claims about anal sex. But they are far less effective during anal sex when used properly. So even IF condoms were used 100% of the time and used properly each and every time, they still wouldn’t be a holy grail. And they still would be less effective than the prescribed use of PrEP. And CDC’s studies show that over a 2 year period, only 16% of men used condoms 100% of time. 16%. And that is why we still have 50,000 new cases a year. And yet people still want to cling to the condoms only as if that will ever get better. It won’t.

May 9, 2015 at 12:05pm

SportGuy

My one question would be are they using condoms whenever they have sex, if not then they are morons! The vast majority of guys are just on this so they can bareback with is NOT what this drug was intended for, however, that is what they are all doing. This was meant to be used with condom use.

May 9, 2015 at 12:05pm

nmuphelps

Take Truvada as well. It may well save your life, or prevent a communicable, and very possibly terminal disease called AIDS.

1-2% of people who take Truvada for PrEP can experience elevated creatinine clearance problems in their kidneys. Everyone who takes Truvada for PrEP is monitored on a quarterly basis for such an issue.

In that case, PrEP is discontinued, a break is taken, kidneys return to normal function, and PrEP is restarted. 98% of those people have no further problems. It’s a very, very, small percentage of people who can’t tolerate Truvada for PrEP long term.

May 9, 2015 at 1:05pm

Arcamenel

If they are using PrEP without condoms they are idiots. Simple as that. I’ve had bareback sex before and I’ve had sex with a condom before, didn’t really notice much of a difference to be quite honest. Also let’s not act like this stuff doesn’t just benefit gays who are more financially secure when the highest rates of HIV infection are within poor communities.

May 9, 2015 at 1:05pm

socaldesign

@SportGuy: Are there studies that show “The vast majority of guys are just on this so they can bareback”? I certainly haven’t read ay.

May 9, 2015 at 1:05pm

da90027

What I find most offensive about this article is why they chose to use the word “sexy guys” which has nothing to do with the article…are they implying “ugly white trash” shouldn’t be having sex? Or if you are a beast you shouldn’t be having sex? LMFAO…

I just wonder if ten years from now all these people taking a daily pill of anything develop liver or kidney damage. Any medication on a daily basis can cause organ trouble down the road.

@da90027: Yes, any medication taken on a daily basis can cause organ trouble down the road. That, though, doesn’t mean a medication taken on a daily basis will cause organ trouble down the road.

For Truvada for PrEP, there is no evidence for your concern. Any elevated kidney function returns to normal after PrEP is stopped. In most of those cases, PrEP can be restarted at a later date with no further problems.

Truvada is the first medicine used for PrEP. Others are in the pipeline that don’t even have the possibility for elevated kidney function. Vaccines are still being researched.

And PrEP can be stopped at any time, without problems. This is far different from being HIV+, where stopping medications means you die.

Stache99

Stache99

@Arcamenel: Please. Of coarse you feel a difference. I’m not disagreeing with you wearing one but lets be real.

Also, I’ve yet to hear of anyone becoming HIV pos while correctly adhering to to Travada. Seems your making a moral judgment rather then a scientific one.

May 9, 2015 at 1:05pm

Stache99

@socaldesign: I’ve never talked to one yet that was wearing both a condom and truvada. I think you’d have to be paranoid beyond belief to be doing both. Not saying those don’t exist too.

May 9, 2015 at 1:05pm

Stache99

@Cam: Yup and the old guard is alive and well here today filling us with the time proven scare tactics minus any shred of proof. Fuck being rational when it’s so much funner to talk then to listen and learn.

May 9, 2015 at 2:05pm

EquesNiger

I had my gay growing-up years in Manhattan and San Francisco during the early to mid-90’s. An HIV infection during those days had only one outcome, and it’s going to take more than hype to get me to assume any drug is a bulletproof shield from that insanely nasty virus.
A few things bug me about the whole Truvada/Prep phenomenon:
– The level of emphasis placed on the drug borders on a mass-hysteria mob-speak, much alike to that on condom usage during the late 80s and throughout the 90s. And while condoms were 99%+ effective at halting infection, taking Prep is almost an encouragement to bareback, and the results there are only allegedly 100% safe (thus, only until they arent).
– The reluctance of the medical community to commit to the drug as being the to the same degree bulletproof against HIV infection as the various blogs assert gives me considerable doubt.
– Those with doubts as to the efficacy of the drug are made to feel irresponsible. Everyday there’s a blog screaming “EVERYONE SHOULD BE TAKING PREP”. It’s a drug with side effects. Condoms don’t ruin liver function.
– Behind the everyday assertion of Prep’s alleged 100% effectiveness as a protective drug, there seems to be also the shrill implication “EVERYONE CAN NOW BAREBACK!”.
– People are only willing to take this risk because of the demeaned perceived threat of HIV due to modern treatments for HIV. These have have rendered what once was the most horrific news imaginable to “ah, I’ll take the drugs, it wont kill me.. no big deal”. Having seen what the virus can do, I’m never going to see it that way.

May 9, 2015 at 2:05pm

Stefan

To each their own. If you’re going to have unsafe sex with lots of random guys you don’t know –go on Prep. Simple.

May 9, 2015 at 2:05pm

Saint Law

@Stache99: While you and the Camster often talk a lot of sense I think you’re off the graph wrong on this.

Donning a condom is not equivalent to taking a medication whose long term side effects have yet to reveal themselves, but whose short-term side effects are many and various. Just google ’em.

And these are the acknowledged side effects. Big pharma has a habit of underestimating the draw-backs of a lucrative product.

I couldn’t give a shiny shit if my resistance to taking a potentially toxic medication makes me a member of “the old guard”.

I’m not taking Truvada and I wouldn’t recommend anybody else do so either.

May 9, 2015 at 2:05pm

LuckyboyLA

@ everyone.. How about you Google the advent of the Birth Control Pill? By 1967, 12 yrs after FDA approval 12.5 million American women were on ‘The Pill’. Which has the same 90+ effectiveness rate and possible nasty, serious side effects like Truvada. Potentially worse actually for a woman. Smoking while using it being number one. But today, the first thing a sexually active Teen goes for is a ‘script for the pill. And she can buy morning after contraceptives that work up to 72 hrs after sex if over 18. Who calls them ‘Pill Whores?’ Only Ultra Far Right Nutjobs during political season. I’ve been poz since 1984. If I could go back and be 30 again, you bet your ass I would be on PrEP. Don’t take PrEP if you don’t want to. But please, if you want to ignore Science, keep your big fat mouth shut and stupid uninformed opinions about Pharm Conspiracy’s, other STI’s, (duh), to yourself. You might unduly influence a mind on the fence. Just smacks of more self righteous ‘Gay Shaming’ from our own community. We truly can be our worst enemies at times.

The fact they’re on prep makes them not sexy. It means they’re butthole gays. And they’re supposed to be using condoms with the prep. What a joke!

They’re all freaks but one guy says, “It is a tactile experience that carries spiritual, mental and emotional weight. I say it’s tactile because it’s skin on skin, plus fluids. PrEP has allowed people to return to cum as a meaningful part of sexuality, not an alien substance to be feared.”

Cum in his rectum means that much to him. lol! He has far too much time on his hands.

May 9, 2015 at 3:05pm

heavylifter

That article doesn’t get past the “truvada wh0re” label, all those guys are taking it for purely hedonistic reasons.

The drug doesn’t stop all the other nasty infections you get from being a promiscuous gay male.

What happens when the next killer virus arrives in town? If all these gay guys are acting like empowered wh0res the virus will spread rampantly like HIV did.

>The level of emphasis placed on the drug borders on a mass-hysteria mob-speak, much alike to that on condom usage during the late 80s and throughout the 90s

No, it doesn’t. The medical and scientific community has seen the data from multiple studies over multiple years in multiple communities across multiple countries. PrEP works and works very well. What you are seeing is a establishment that only had one real technique that worked — condoms — understanding that PrEP, along with positive people who are virally suppressed, are the new advances in the fight against HIV.

>And while condoms were 99%+ effective at halting infection,

Condoms were never studied against HIV, so we don’t know know efficacious they are. Condoms have been studied to see how effective they are against HIV at the population level. Note, there’s a difference between “efficacy” and “effectiveness.” Condoms are somewhere in the neighborhood of 70% effective at halting HIV. Different studies, different numbers, different quibbles over the data, but that’s what the CDC is working with now.

PrEP has been studied for efficacy — more or less meaning the individual level — and for effectiveness — more or less meaning at the population level — which is why the sea change has happened. When taken daily, in study after study, PrEP reduces infections by 99%. It’s 86% effective at the population level. It’s works far better than condoms do.

> taking Prep is almost an encouragement to bareback

Barebacking happens regardless of PrEP or condoms being emphasized. PrEP is another tool to prevent HIV from being transmitted.

>The reluctance of the medical community to commit to the drug as being the to the same degree bulletproof against HIV infection as the various blogs assert gives me considerable doubt.

We’re about one year into having conclusive evidence of how well PrEP works, after multiple years of having good evidence PrEP works. Same thing happened with condoms. No different here. With everything from the CDC to the World Health Organization now behind PrEP, things are changing.

>Those with doubts as to the efficacy of the drug are made to feel irresponsible. Everyday there’s a blog screaming “EVERYONE SHOULD BE TAKING PREP”.

I think you have this backwards. Blogs are noting how effective PrEP is and encouraging people to consider using it. Health educators are noting that if condoms work for you great. You can add PrEP to the mix. If you aren’t using condoms or using them inconsistently, PrEP definitely should be considered. If people want to switch from condoms to PrEP, that’s between them and their doctors.

>Condoms don’t ruin liver function.

Neither does PrEP. This objection isn’t relevant to PrEP.

>– Behind the everyday assertion of Prep’s alleged 100% effectiveness as a protective drug, there seems to be also the shrill implication “EVERYONE CAN NOW BAREBACK!”.

I remember a similar objection lodged against condoms. “Everyone can now use condoms to fuck as much as they want!” The implication in both cases is that people shouldn’t be having sex in whatever way the poster believes people shouldn’t.

>These have have rendered what once was the most horrific news imaginable to “ah, I’ll take the drugs, it wont kill me.. no big deal”.

Yes, PrEP pretty much takes HIV out of the running as a possible infection. The regular STI checkups that are also part of PrEP increases the likelihood of any other infection being caught and treated. How much or how little sex a person should have isn’t addressed here. That’s for an individual to figure out — and that’s a far better thing to figure out when death isn’t a consideration.

>Having seen what the virus can do, I’m never going to see it that way.

Which is what your entire, factually unfounded argument boils down to: PrEP isn’t right for you. Which is fine. If you are comfortable with whatever you are doing now, great. You are under no obligation to change.

There are 50,000 new HIV infections each year. Condoms only haven’t worked to stop that. Now, between condoms, PrEP, and ARV, we have vastly increased odds of reducing, even eliminating, those new infections once and for all.

In short, this isn’t about you.

May 9, 2015 at 3:05pm

juankarl28

I dont understand why anyone in their right mind would put their health on the line for a one night stand, its unfathomable. Also, please use a condom and don’t over use the drug because eventually a drug-resistant strain of the virus might mutate.

May 9, 2015 at 3:05pm

Billy Budd

I will never take this medication. Never ever. Condoms are much safer and affective. I am sure that resistant strains of HVI will come up very soon and the drug will be useless.

May 9, 2015 at 3:05pm

notevenwrong

Where so you all get that Truvada ruins liver function, never mind thyroid? It does not. Maybe inform yourself about the facts before pulling scare comments out of your asses.

May 9, 2015 at 3:05pm

Stache99

@heavylifter: ..and neither will a condom for most of the other virus’s. Shall we just abandon those too and stop having sex because that’s the only sure way of no risk.

Your argument is more about he moralizing then any science.

May 9, 2015 at 3:05pm

notevenwrong

And if you are gay and worried about other STIs, get the hell vaccinated against HPV and hepatitis already.

May 9, 2015 at 3:05pm

JDean

bahahaha, sexy! These?

These are at best 5 average and below average dumb whores. There isn’t a single 10 in this list. Guy #1 being about a 7, and that’s stretching it.

Robert Gallo, one of the most famous HIV researchers is “not on that PrEP wagon” as he put it at a conference.

Julio Montaner, one of the Truvada pushers admitted at an AIDS conference he “hopes no one takes it longer than 3 years” because of the unknown effects

But hey take a toxic pill if that’s your excuse :)

May 9, 2015 at 3:05pm

Stache99

Some of you that are getting your panties all tied up in bunches need to understand that PrEP is a good way of phasing the virus out over time. Condoms are not working and this isn’t just about YOU. This is the future of prevention whether you like it or not.

heavylifter

A condom WILL reduce rates of other types of infection, not perfect but better than TRUVADA.

But as long as the likes of you Stache99 continue to deliver an Academy winning interpretive performance of Sodom and Gomorrah, STI rates amongst gay men will continue to be at epidemic levels.

The gay population is a sitting duck for the next virus that emerges from the Congo jungle.

You whine about “moralising” because virtues like “self restraint” and “personal responsibility” are meaningless to you.

May 9, 2015 at 3:05pm

notevenwrong

Regarding cost:

Many (most?) health insurance policies will pay for PrEP. The company that makes it has a program to cover much of the cost for people without or with insufficient insurance. Medicaid in several states pay for it. There are a number of outreach-type programs providing PrEP for free in certain cities/states.

May 9, 2015 at 3:05pm

lauraspencer

Do your research. You can easily google to find the side effects of Prep. One of several is “•changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).” This is known as lipodystrophy and is often seen in people with HIV. A wasting in the face, belly and butt area. After 8 months I can see the wasting in my friend’s face that he resembles someone who has HIV.

As for the line about condoms not working. It isn’t that condoms don’t work. It’s that many gays don’t use them. If people practiced safe sex for the past 30 years and used condoms we wouldn’t have the epidemic we currently have. If a guy can’t be responsible to put a condom when he has sex a couple times a week I don’t believe he will remember to take Prep daily.

As others have also said on here many guys are using Prep without condoms just so they can bareback. That isn’t supposed to be the case. And those that do are stupid.

On this site alone we have seen the different success rates of Prep over the past couple years. Originally it was 93% effective and then it was in the area of 87%. I fly a lot. If I flew a 100 times in a year knowing that 13 times I’m going to crash or even y you better believe I would take the train.

May 9, 2015 at 4:05pm

lauraspencer

Do your research. You can easily google to find the side effects of Prep. One of several is “•changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).” This is known as lipodystrophy and is often seen in people with HIV. A wasting in the face, belly and butt area. After 8 months I can see the wasting in my friend’s face that he resembles someone who has HIV.

As for the line about condoms not working. It isn’t that condoms don’t work. It’s that many gays don’t use them. If people practiced safe sex for the past 30 years and used condoms we wouldn’t have the epidemic we currently have. If a guy can’t be responsible to put a condom when he has sex a couple times a week I don’t believe he will remember to take Prep daily.

As others have also said on here many guys are using Prep without condoms just so they can bareback. That isn’t supposed to be the case. And those that do are stupid.

On this site alone we have seen the different success rates of Prep over the past couple years. Originally it was 93% effective and then it was in the area of 87%. I fly a lot. If I flew a 100 times in a year knowing that 13 times I’m going to crash or even 7 times you better believe I would take the train.

May 9, 2015 at 4:05pm

notevenwrong

@lauraspencer: “You can easily google to find the side effects of Prep. One of several is … lipodystrophy.”

No, lipodystrophy is not listed as a side effect of PrEP. You may be referring to its being listed among the side effects of Truvada, but that is within the context of historical studies of people who (a) have HIV, which itself is thought to cause lipodystrophy, and (b) Truvada being used as part of drug regimes containing [email protected] inhibitors in addition, which are thought to be the main class of drugs contributing to the condition.

PrEP studies have not found lipodystrophy.

Re: “If a guy can’t be responsible to put a condom when he has sex a couple times a week I don’t believe he will remember to take Prep daily.”

You know that is not true, if you are a woman as your name suggests, because people could say the same about women and birth control.

May 9, 2015 at 4:05pm

SportGuy

The majority of prep users only use it so they can bb, which is not what this drug was intended for. If someone is so set on putting there life in the hands of a drug just so they can feel some liquid inside them, I don’t ever want to know them or date them. Sad that gays can’t use the drug as intended, which is with condoms! However, not surprised with all ageism and racism.

May 9, 2015 at 4:05pm

notevenwrong

Let’s not provide birth control pills. Let’s insist that straight people always have sex with condoms too.

May 9, 2015 at 4:05pm

lauraspencer

If you forget to take birth control you will not end up with a deadly illness. You will end up with a child that might make you wish you were dead, but the little rugrat isn’t going to kill you. Yes, I know people who have forgotten to take their birth control.

I can hardly remember to take my medicine for high cholesterol and sometimes skip for a couple of days.

May 9, 2015 at 4:05pm

notevenwrong

@SportGuy, sex without condoms is also about sensation. When I top, the difference is like having sex in color as opposed to grayscale. And when I bottom, I can also feel the difference, not least of which is that condoms chafe my ass much more than bare skin.

May 9, 2015 at 4:05pm

notevenwrong

@lauraspencer, HIV is not so deadly any more; however, I get the point you are trying to make. At least a pregnancy is curable by getting an abortion.

Evidence indicates that you can forget PrEP a day or two a week without loss of effectiveness. However, I would be the last to recommend that.

I think what you miss is that forgoing condoms is not about forgetfulness. I have had a lot of sex without condoms, even before PrEP (which I have remembered to take every day for two years). I didn’t use condoms because of other reasons – not because I “forgot” to use them.

heavylifter

How about you start practicing self restraint, if you even know what that is.

May 9, 2015 at 4:05pm

courthousedoc

@heavylifter: I’m really sorry if you are so ugly that no one is interested in you. Because that is what that moralizing always equates to.

May 9, 2015 at 4:05pm

EquesNiger

@Jody:
Interesting points. However, I disagree with you that “this is not about me”, as it’s a fairly substantive decision each individual needs to measure for themselves. This is about each and every person barraged by this stuff – individually. There’s no room for group-think on this one.
If you’ve adopted a lifestyle and sexual conduct position as a result of the information you have on this issue, for your sake, I do hope your assertions and hopeful thinking prove correct.

I started PrEP in January, after looking into it for a few months and speaking to a few different clinicians.

Before anyone jumps on the “truvada whore” train, I’ve had sex with exactly three people in about 10 years, and none of that was anal sex (something I’m not really into). I’m not into kink or waterports or any of that kind of thing. I’m a pretty regular guy who is very far from the one-night-stand mentality.

I started PrEP because the stats on HIV – especially the number of people who have HIV without knowing it – freak me out. Is PrEP 100%? No, but combined with condoms, it’s damned near – and closer than with condoms alone. That extra 10-20% (depending on who you ask) is enough to drop my OCD-intensified anxiety levels down to a reasonable level.

Tack on the three-month checkups and having a clinician to talk to who not only knows about gay sexual health issues but is open and enthusiastic about talking about them (I brought up the HPV vaccine on my last visit; I’ll probably be getting that shortly), and I can honestly state that my sexual health, behavior, and comfort are far better now than they were before I started.

Other than some dizziness at the start, I haven’t had any side effects (which, contrary to posters above, is pretty much solely related to kidney function for HIV- persons; I work for a hospital and can pull up the studies if you want). It’s $35 a pickup for me, and soon that’ll be for three months’ worth.

For me, it’s worth it until an HIV vaccine gets through trials (a few are in the works); I’m not planning on being on this for the rest of my life.

May 9, 2015 at 5:05pm

LuckyboyLA

@ Saint Law and others ‘Big Pharma, Big Pharma’. Oh yeah, and 9/11 was an inside job by the Bush Administration too. How do you guys get out of bed every day w/o wearing an aluminum foil hat? I hope men reading these posts and thinking of PrEp don’t give a ‘shiny shit’ to your opinions. You are not ‘Old Guard,’ sound lots more like any garden variety conspiracy theorist.

Oh yeah, and @ EquesNiger.. just how many scientific research abstracts have you read on this subject? I’ve read 8-10 at least. What ‘Medical community’ do you refer to? AHF? Every one of your points refers back to a blog or your own opinion. This one REALLY gets my shit hot. “Behind the everyday assertion of Prep’s alleged 100% effectiveness as a protective drug, there seems to be also the shrill implication “EVERYONE CAN NOW BAREBACK!” Alleged’ by you, not Science, buddy. Who do you think you are to make such a statement? And all caps? Really? Your entire post reeks of an Allgemeine SS outlook. Google that one why don’t you? Ought to prove a real eye opener. I luv throwing history at those who opine and only show their ignorance online.

heavylifter

Keep riding the c0ck carousel but only YOU are responsible for the poor life choices YOU have made. No one else is obligated to clean up your messed up life no matter how “oppressed” you believe you are.

May 9, 2015 at 6:05pm

lauraspencer

Why in the world are you polluting your body with chemicals if you don’t have anal sex and have had very few partners in the past 10 years? You sound smart and responsible. The money you have to pay and possible long term side effects from such strong medication doesn’t seem worth it or necessary in your case.

May 9, 2015 at 6:05pm

Stache99

@heavylifter: I guess we should cut people off that have diabetes and heart decease too. Those lazy unhealthy slobs. While were at it no more $ for birth control to all those sluts having sex without guilt.

What a conundrum though. Abortion vs birth control. Hmm…what’s a jesus freak to do. I know. I’ll just bury my head in the sand and pray. Lol

May 9, 2015 at 7:05pm

Kieru

@courthousedoc: Truvada is only proven effective against HIV-1. There are multiple strains of HIV though HIV-1 is the most prevalent in the United States. It has also proven to be less effective at certain drug-resistant mutations.

Further, the efficacy of Truvada vs. Condom usage is a subject of much debate. The study that Truvada references for their 96%+ statistic is based on the highest statistical effectiveness, a level they admit the study itself did not display (people didn’t use it exactly how it was supposed to be used every time)

Studies that factor in forgetting a pill show a preventative level much more in line with just using condoms, which makes some people that Truvada is being misrepresented or worse… being promoted as a VERY expensive alternative to condom use.

May 9, 2015 at 7:05pm

Merv

If people really can’t control themselves, then Truvada is better than the alternative. But, I think it’s sad people feel they can’t control themselves. I had bareback sex exactly once in my life, and that was by accident. I was young and dumb, and although I noticed that it felt 100 times better than normal, I didn’t make the connection that it was because the condom had failed. I totally freaked out when I was done and noticed the shredded remains of the condom. I remained freaked out until six months later when I got my negative test results. That was in the 1990s, and was the last time I had anal sex with or without a condom. For me, it’s really not worth the risk, even with condom and Truvada. I have a very low risk tolerance when it comes to that sort of thing, and it’s not even enjoyable when I’m constantly worried about getting infected.

May 9, 2015 at 7:05pm

courthousedoc

@Kieru: Let’s talk about the real world, not the study world. In the real world, where patients self-select by asking their doctor about going on Truvada, frequently even having to fight their doctor or their insurance carrier to go on it, they don’t forget their meds. I didn’t know if it would work for me. I’m the world’s least compliant patient. I’ve never completed even so much as a 10 day course of antibiotics in my life without missing doses. But in 8 months on Truvada I’ve never missed a dose. And my other meds I always missed I’m now 100% compliant on, so it’s improving other parts of my health. And that is exactly what a lot of other real-world Truvada users are reporting. Not the limited trial participants. I’m seeing my doctor routinely. I’m getting screened for HIV and all STIs every 3 months, which is as much or more than almost any one else not on Truvada. Guys who are condoms only think they are safe and don’t get tested nearly as often if at all and then it is only for HIV, not the full panel of STIs. And to date, there has been not one documented case of a someone who has taken their Truvada every day who has ever seroconverted. Not one.

Condoms are at best 91% effective at preventing pregnancy according to the CDC. They were designed for vaginal use and never intended for anal sex. And the manufacturers never claimed that they were. Their failure rate in anal sex is far more than the optimal 91%, even when used properly. Some put their effectiveness at about 70%. And a 2 year CDC survey showed that over that 2 year period, only 16% of men reported 100% compliance with condom use. 16% of men. Condoms were the best option we had in the 80s and 90s, short of abstinence. But they weren’t foolproof, but we were sold that they were. They were safer sex, not safe sex. And it isn’t only barebacking that is still leading to 50,000 new cases a year because that rate is unchanged in decades. It is condom failure that is contributing to that rate as well. And denial of that fact is sticking our heads in the sand. Yet the fight against Truvada is effectively saying we’re content with 50,000 new cases every year ad nauseum. Because short of a cure or a vaccine, nothing will change that. Nothing.

May 9, 2015 at 7:05pm

Realityis

To any and all advocators of PrEP:

First off I’ll say it again. The writer of this article is a moron. Nothing is sexy about PrEP. Absolutely nothing unless you like side effects and possible lipodystrophy. I have it and I don’t think it’s sexy at all.

Secondly, this Damon guys seems to be a joke too. He says “I started PrEP in 2011 because I wanted to maximize pleasure,”. While I understand the nuance of his statement, the first thing that comes into my mind is bareback sex. Now don’t get me wrong, bareback sex is great, but I wish I had never let my boyfriend lie to me about his status before I gave it up to him.

To the the guys who say the makers of Truvada don’t advocate taking the drug and using a condom together, this is from their website: TRUVADA is a prescription medicine used in 2 different ways: first is for HIV positive people like me and the second is to help reduce the risk of getting HIV-1 infection when used together with safer sex practices. DUH. What do you think that means STUPIDO! Also notice the “help reduce the risk” part… to me that implies that it will not always take the risk out of the equation so why take it alone and risk it?

To the STUPIDO guys who don’t think Truvada can cause Lipodystrophy read this from there website: Serious side effects of TRUVADA may also include: Changes in body fat can happen in people taking HIV-1 medicines.

Now I don’t care if you take this med or not. I am, but only cus I have to and I am already living with the Lipodystrophy but if I can convince just one person not to take this drug, I’d be happy. Body fat changes are no joke and irreversible. I’ve sunken 15000 dollars into trying to make myself look better and nothing worked or was permanent. Also it’s not fun wearing pants and long sleeves in summer to hide those veiny limbs. Hell, I was a fitness instructor for 10 years with a very nice body…. and to the guy who thinks it’s the HIV that causes lipodystrophy and not the meds…. keep thinking that my naive dude.

First off we should be demanding a cure for this disease not making men and women rich off of our ignorance, fear, and stupidity. Why aren’t these meds available in generic forms yet? Because then they wouldn’t be profitable. Now who really wants to help us? Not Big Pharma…… or only if it makes them rich. Wake up people. Please…

I actually hope non-life threatening side effects happen to people taking PrEP. Maybe than we would collectively understand that a CURE has to be found, and if there is one already (which I personally think it is), it has to be made available.

May 9, 2015 at 8:05pm

Realityis

Oh and another thing that irk’s the hell out of me is that insurance will cover this medication for negative men and woman but won’t pay for me to get the painful injections in my face or the liposuction in my back….

May 9, 2015 at 8:05pm

Realityis

but will gladly pay for my antidepressants……. what a f’ing joke.

May 9, 2015 at 8:05pm

courthousedoc

@Realityis: First, I’m sorry you are going through the lipodystrophy. But even according to the Gilead website and prescribing information, that is only a risk factor for HIV-1 positive patients, not for negative patients, so patients using Truvada for PrEP, which was Jody’s point is correct. Read the package inserts. I just did to make sure.

But the insurance company sure as hell should be paying for those injections for you. Fuck yes. There is absolutely no excuse not to. This is like them paying for bariatric surgery. They then will also cover the cosmetic surgery to remove the excess skin left because of the weight loss. This is the side effect and it should and must be covered. It is reprehensible that they aren’t and I’d fight like hell to get them to.

And Truvada will be coming off patent in 2017. Whether a generic manufacturer will pick it up is unknown, but hopefully so which will cause the price to plummet.

May 9, 2015 at 8:05pm

sfguy94118

@Random: And seatbelts don’t prevent car accidents. But it’s still a good idea to wear one :)

May 9, 2015 at 8:05pm

jason smeds

I think Truvada-takers are pathetic. It’s a chemical that your body can do without. I sometimes wonder if those who take Truvada are also into adding other chemicals to their bodies.

There appears to be this careless approach by some gay men as to what they put into their bodies. It’s almost like a free-for-all. It’s an attitude that extends all the way from drugs to promiscuity.

Then they wonder as to why they catch diseases and end up extremely ill….

May 9, 2015 at 9:05pm

martinbakman

You are posting comments too quickly. Slow down.

May 9, 2015 at 9:05pm

courthousedoc

@jason smeds: You obviously don’t know what in the hell you are talking about. Everyone I know who is on Truvada has made a deliberate, conscious decision in consultation with their health care provider, after careful consideration of the available scientific evidence, weighing the risks and our individual situations to determine what is best for us. There is no rash, sudden impulse decisions here. Guys who do drugs don’t take Truvada because they probably aren’t responsible enough to be taking it every day. They also aren’t responsible enough to be using condoms all the time either, sadly. But Truvada users believe the scientific evidence clearly shows us that when taken daily, Truvada clearly is superior to condoms at preventing HIV infection. It isn’t close. Condoms by themselves are less forgiving than Truvada every day. They simply are. Whether you want to admit it or not.

May 9, 2015 at 9:05pm

Pete

In college I did a lot of safe-sex counseling. The first time I was unsafe was under the worst imaginable circumstances. I met him in a club, he was hot, I was horny, and I just didn’t think about condoms. In fact, he was the one who pointed it out after he was in me. “Do you want me to stop?” “Holyjeezusfuck no!” was my response, because, yes, it felt so good. I always imagined I’d be totally freaked-out after an unsafe encounter but instead I felt something completely unexpected: sexy! This beautiful stud had just banged a load into me. When I got home and took off my underpants the reeked of his cum. Yes, that’s an important experience for me.

May 9, 2015 at 9:05pm

jason smeds

If you want to give your hard-earned cash to the rich pharmaceutical company that makes Truvada, go right ahead. You’re wasting your money. The owner of the company will very much appreciate your donations, however.

If you have any sense, you will realize that the best health-care is in the choices you make. Stay away from drugs, stay away from promiscuity…you can’t get any more basic than that.

Unfortunately, there is a core group of misguided gay twits who think they can pop a pill for everything they might suffer as a result of their choices. Twits, twits, twits. Imagine, what you are turning your body into – a boiling chemical factory that will ultimately collapse under the strain of all the added chemicals.

May 9, 2015 at 9:05pm

courthousedoc

@jason smeds: Now let’s see. I’m a 60 year old man who takes 2 mild anti-hypertensive meds because of genetics (thanks Mom and Dad). Body fat of 12%. Never done a drug in my life (not even pot). Been drunk exactly twice in my life (once when Henry Aaron broke Babe Ruth’s home run record). I’m in the gym 6 days a week. And I like sex. And I’ll lay you 10:1 I’m a hell of a lot healthier than you. You were saying?

May 9, 2015 at 10:05pm

Stache99

@jason smeds: Yeah, those women that you disdain so much must all be really pathetic for putting those chemicals ie birth control pills into their bodies too. All just to have sex!

May 9, 2015 at 10:05pm

PrEPWarrior

Man, so many moralizing reactions to this piece. I liked it. Look folks, PREP is not for everyone, but, it’s great for a lot of folks. 50,000 new infections a year in the US alone.

If biomedical aren’t your thing, that’s fine, don’t use them. But please, don’t brow beat those that do. They’re being responsible to themselves and their partners.

May 9, 2015 at 10:05pm

jwtraveler

@Stache99: Fear of contracting a deadly disease and taking precautions to prevent that is not “paranoia”. It’s intelligent, rational behavior. I’m not opposed to people taking Truvada, but I think it’s foolish to give up using condoms. No one is going to fuck me without a condom regardless of whether I decide to take PreP for the obvious reasons already stated. One factor that is never mentioned is the risk that another deadly bug could come along, just as horrible as HIV and wipe out millions more of us before we know what hits us, just as happened with AIDS. The risk of it spreading like wildfire will be greatly reduced if we’re using condoms, and the way gay men fuck like bunnies that’s a significant risk. We need to stop eroticizing exposure to infections carried by semen.

May 9, 2015 at 10:05pm

jwtraveler

@martinbakman: Me too. I never thought that my fingers could move faster than a computer could process the input.

May 9, 2015 at 10:05pm

LuckyboyLA

@Realityis I’ve been poz since 1984. Took early protease inhibitors and look like it. Skinny limbs and a hard belly. Sorry you spent $15k for nothing. A competent Dr ought to have told you Egrifta/tesmorilin only works on the most severe cases and then just so much. A 3″ loss in the waist for some is a real quality of life issue. That Dr from UT Texas told me I better get my affairs in order on the phone mind you in 1984. Yeah, well I’m mighty happy to have been here and still here despite it all. I know in fact insurance has and can be made to pay for liposuction of visceral fat on the upper back. You and your Dr either aren’t persistent enough or going about it wrong. If you spent as much time documenting how that affects your quality of life and less time bitching, maybe just being a little happy you’re not dead, things would go better for you all around. BTW, I wear short sleeves and shorts. It’s not that diff to buy the right cut of clothes for a skinny body. Yes I’d look awful in cargo shorts so I don’t buy them. I also buy XL but slim cut shirts. Room for my belly but slim looking overall. I’m 62 now and still into my kink scene. if I were as bitter as you over all the shit storms I’ve been through, I’d never leave my house.

May 9, 2015 at 10:05pm

Realityis

@courthousedoc: no where does it say that the lipodystrophy side effects are exclusive to people who already have HIV. Please don’t feed bad information to those who are hopeful of this med. Read what are the other possible side effects of Truvada? On their website.

May 9, 2015 at 11:05pm

jwtraveler

@Pete: What’s your point? That you knew better, but did something stupid and dangerous anyway? That you didn’t care because he was so hot and it felt so good? That you’re happy that you risked your life for one night, or a few minutes, of ecstasy? And that acting so stupidly made you feel sexy? Is that why it was such an important experience for you? So let me see if I got the message: risking death is the ultimate aphrodisiac! Is that it?
No thanks. I’d rather live a long, healthy life with a little less ecstasy.

May 9, 2015 at 11:05pm

Realityis

@LuckyboyLA: f u dude. I bet people look at you in disgust. Bitch. But hey, if you don’t mind it.

May 9, 2015 at 11:05pm

LuckyboyLA

@all of you trying to reason with the Anti-Truvada gang. There’s an expression for what you’ll get in return. “Pissing into The Wind’. Or another is ‘Like Talking to a Brick Wall’. Their opinions are absolute and we’re all as wrong as Flat-Earth Society members or 6000 yo time line Biblical absolutists. Which BTW don’t they come off sounding a lot like? Holier than Thou?

May 9, 2015 at 11:05pm

courthousedoc

@Realityis: From the Prescribing information on the Truvada Website. This is the information given to doctors: “5.6 Fat Redistribution
Redistribution/accumulation of body fat including central obesity, dorsocervical fat
enlargement (buffalo hump), peripheral wasting, facial wasting, breast enlargement, and
“cushingoid appearance” have been observed in HIV-1 infected patients receiving
antiretroviral therapy. The mechanism and long-term consequences of these events are
currently unknown. A causal relationship has not been established.” It has never been observed in any person ever taking it for PrEP. Ever. Sorry, but that is a fact.

May 9, 2015 at 11:05pm

LuckyboyLA

@Realityis Ahh yes, the self loathing runs deep in this Sith Lord lol. Yes, I’m so ‘disgusting” I frighten small children at Trader Joes. But not half so much as you poor guy are on the inside. Sticks and stones may break my bones but a mean girls Flames can never hurt me. Do it again, I double dare you. Show all of us the real you. This thread is more entertainment than a serious discourse anyway.

May 9, 2015 at 11:05pm

LuckyboyLA

Guys on Prep don’t have HIV you Big Dope. Therefore not applicable to them. Jeeze, what does it TAKE to get through to you people?

May 9, 2015 at 11:05pm

martinbakman

Kudos gay men for reappropriating the word “hore”, and since kwear-tee will probably block my post for using that word I’ll reappropriate the spelling.

But it’s heartening to know that all of us use that word in only a positive sense.

Most of all, kudos to kwear-tee for using that word in this piece, and continuing to lead us in our charge to love ourselves unconditionally.

May 9, 2015 at 11:05pm

courthousedoc

@LuckyboyLA: We may be pissing into the wind. But did you ever consider the possibility that we might be into water sports? :)

May 9, 2015 at 11:05pm

Realityis

@courthousedoc: just because it hasn’t been observed doesn’t mean it won’t be in the future Positive. Also I have tried to get insurance to pay for these things and have had letters from my therapists and my doctors and nothing. So don’t tell me it’s covered by insurance.

And to luckyboyLA if you’re comfortable enough with it dude more power to you. All I know is people do stare. Happens on the subway all the time because I catch them. If you want to call it self loathing or bitterness, so be it, but guess what, I care what people think about me and I want to continue working without having to always answer questions.

May 9, 2015 at 11:05pm

Realityis

@LuckyboyLA: I never said guys on prep are HIV positive. Now who’s the dope. Please read my comments. All people who take these medications are at risk, and the makers of truvada admit it.

May 9, 2015 at 11:05pm

Realityis

@Realityis: and what you wrote is actually true. I don’t dispute that at all. But if you read the side effects part of the website It clearly says that this medication can cause body fat redistribution in anyone who is taking it.

May 9, 2015 at 11:05pm

Realityis

oops meant the last post to courthouse on

May 9, 2015 at 11:05pm

courthousedoc

@Realityis: The website and the prescribing info is different. The FDA must approve every single word of the prescribing info before it is distributed . Every claim, every statement either by omission or commission, must be backed up by study. And if it had been observed in a negative person in any trial ever, it would have been in the prescribing information. They could not have used the phrase ” have been observed in HIV-1 infected patients receiving
antiretroviral therapy” if in fact a Non-HIV-1 infected patient had been observed with lipodystrophy. It simply couldn’t happen. FDA doesn’t have to approve the websites beforehand so why it’s there other than lawyer precaution, I don’t know. But scientifically, to FDA’s satisfaction, in all studies done, it has never been shown to cause lipodystrophy in negative patients.

May 10, 2015 at 12:05am

PrEPWarrior

seaguy

@Prinny: You are a horrible person to say it would be hilarious if they all got HIV. And your statement that it does not protect against other strains of HIV is complete nonsense. Truvada used as PrEP protects against all strains of the HIV virus. As for other STI’s all of those who are on PrEP are well aware of the fact that they are not protected from other STI’s. Some protection is better than none which it seems you would advocate. News Flash honey preaching use condoms to gay men over and over has proven inefective at preventing new cases of HIV so it’s time to try other methods as well. People like you who go around spreading false information only make things worse. But Karma will get you for that.

May 10, 2015 at 1:05am

seaguy

@jason smeds: Well you are the pot calling the kettle black then cause your pathetic to cast judgement on others for the decisions they have made regarding their health. What gives you the right to judge someone else? You obviously have not expertise in the medical field because the misinformation and lies you spread about Truvada clearly show that you are not qualified to be judging so maybe you should try minding your own business.

May 10, 2015 at 1:05am

seaguy

@Billy Budd: I am sure you are someone who does not like progress, or change and you will go so far as to wish that the very progress you dislike fails. Gee if we were all like you we would still be back in the stone age.

Condoms might work just fine for you but there is overwhelming evidence that they do not work 100% of the time for others, as they can break….you know the rest. Do those who are using PrEP wish that your condoms would break? Probably not so maybe you should stop wishing for truvada to fail. Karma can be a bitch you know.

May 10, 2015 at 1:05am

jason smeds

If someone is spouting distortions, it is your moral right to call them out on it, just as you would call out liars, cheats, thieves, hypocrites.

The sad thing about the Truvada-pushers is that they sincerely believe their little pill will protect them from their own poor choices. Here’s a memo to write into your dashboards: NOTHING will protect you from your own poor choices except maybe a few extra brain cells.

May 10, 2015 at 1:05am

SonOfKings

I have a problem with this article. I am a suporter of PrEP as a harm reduction measure, but these guys are being intentionally vague about what they are actually doing sexually that necessitates PrEP. I suspect they are all barebacking. If that’s the case, I wish they would come out and say, “I’m on PREP because I like to bareback.” This BS about “maximizing pleasure” is an annoyingly incomplete explanation.

May 10, 2015 at 2:05am

benandy

One of my friends here in LA not only went on it, but convinced Kaiser Health Care to pay for it. He’s monogamous. His husband is NOT. I assume their relationship allows for this. They’ve been together for many years and I think that neither are POZ. They got married the first day you could here, pre-Prop Hate. It wasn’t easy to get it prescribed, but, making the case that they have to “take care of him if his husband brings home the infection and gives it to him anyway” and PreP is cheaper than HIV meds, they decided it was $$ in the black to give it to him.

Maleko

spiffy

Of all the comments I’ve read so far, maybe only one person is using Truvada with condoms?

Most other pro-PreP people not only are for the medications, but seem to be anti-condom as well. If not outright hostile toward condom usage, they at least will either gloss over it, or try to emphasize how PreP is more effective than condoms.

Using correctly, it is proven that HIV cannot pass through a latex barrier, no? Or is that going to be up for debate as well?

May 10, 2015 at 5:05am

stuartaidanlover

Colby Keller! See his new videos at colbydoesamerica.com. FREE (recommended by a fan).

May 10, 2015 at 7:05am

Realityis

@LuckyboyLA: I want to apologize to you. I’m sorry. What I said to you was uncalled for and very insensitive and never would have been said 10 years ago.

May 10, 2015 at 8:05am

courthousedoc

@spiffy: Most people I know on PrEP, and I am on PrEP, are not anti-condom, we just prefer not to use them ourselves. But most of us let our partner make the call. It is his comfort level. We are on PrEP for ourselves, for our own protection, our own health. Many, maybe even a majority prefer to play bare, but most will use a condom if a partner wants to. Some still use a condom 100% of the time, some only play bare. So it depends on the person and the situation. Is it with a monogamous partner who is poz? Is it a trans man or woman? Is the partner status verifiable? Are they on PrEP or poz-undetectable? Are we a woman on PrEP because our male partner is Poz and I want to get pregnant (and yes I know of babies being born because of PrEP). All these go into the decision as to use a condom. And ultimately is the person we are with comfortable being bare or do they want a condom?.

We cannot say that condoms are 100% effective if used properly because real world experience tells us they never are. Condoms are only 91% effective at preventing pregnancy according to the CDC and condoms were designed for vaginal sex, not anal sex. They are less effective in anal sex. That is a given. We know for 100% certainty that condoms do not protect the top if the bottom has an active outbreak of herpes, so can we say for certain that 100% of the time latex provides protection against HIV? No we can’t. From the 1980s-2000s, condoms were our best and only option, short of abstinence. It was safer sex, but it wasn’t “safe sex”. We were sold a bill of goods as far as that is concerned. And 50,000 new cases of HIV every year show that. Because that isn’t all because of people barebacking. A measurable number of those cases occurred because of condom failure.

When taken properly, as directed, every day, PrEP is more effective than condoms at preventing HIV. That’s just what the numbers tell us. It is that simple.

I don’t take PrEP for anyone but myself — to keep me safe. I am damn near religious about taking my meds and following the testing protocol. And most people on it are. And those are the real world facts.

May 10, 2015 at 9:05am

courthousedoc

@benandy: I know enough people in the Kaiser program to know that if your friends are on PrEP they are negative. First, that is the major requirement — you cannot be on PrEP unless you are negative and stay on negative. Kaiser requires PrEP be administered by an ID doc (Infectious Disease) who specializes in HIV treatment. Yes it is tough to get because they make damned sure you are negative because of the severe consequences that can occur if you ARE positive and begin PrEP. So trust me, your friends are negative. And a few months ago Kaiser issued a report saying that not one of their patients on PrEP had ever seroconverted. Your friends are negative. 100% guaranteed.

May 10, 2015 at 9:05am

notevenwrong

It is not so easy to “just use condoms instead.” For many guys, condoms diminish sensation to the point of making sex unenjoyable. For me it is not even worth the bother. The latex tends to chafe the bottom. And many guys cannot sustain an erection while putting on and wearing a condom, making their use incompatible with having a healthy sex life.

When the need for them arose, condoms were only meant as a temporary measure until something better came along. I am glad that something finally has.

May 10, 2015 at 9:05am

joey

why not use BOTH condoms and this drug, getting AIDS can’t be worth a “better feeling” ..it just can’t. lets ask a poz person if that great fuck and that wonderful bb feeling was really worth it?

May 10, 2015 at 10:05am

wpewen

I was in the first study of HIV in 84 at UCLA. Even then, it was easy to make choices with minimal risk. The problem I saw in the 80’s was people declaring their “right” to have unprotected sex. Everyone should make their choices carefully, but believe me, you may not “have to” have as much action as you think you do-lol. Nice work if you can get it, but best to always error on the side of caution.

May 10, 2015 at 11:05am

Realityis

courthousedoc

@joey: We don’t “Have to” have sex at all, do we? That is the only safe sex there is, isn’t it — none? For everyone else it is where do we draw the line. What risk is acceptable, what do we believe the risk really is? I believe in science, I believe in statistics, I believe in progress. Others believe that the earth is flat, baby jebus rode dinosaurs and the sun revolves around the earth. And they believe because condoms were the only way to protect ourselves once, no matter how flawed or incomplete they were, that is the only way we will ever have to protect ourselves. I don’t. No one gets to make up anyone else’s mind on where they are on the risk continuum and what they believe scientifically. I believe the statistics and studies show that PrEP, when taken every day provide complete protection for my needs. “But why not condoms”? Do you ask that of women on birth control pills, because birth control pills fail too? No one EVER asks that question, do they? They’d get more protection if the men used condoms, wouldn’t they? But no one asks.

Condoms are suboptimal at best to me. If my partner wishes to use them, I will be happy to oblige them, without fuss, without a problem. But my preference is without. Because I believe the science and statistics tells me I get the protection I need. Because I know my compliance with taking my meds is 100%. The minute it isn’t I will re-assess the situation.

May 10, 2015 at 12:05pm

joey

i believe in science too, nothing is 100%, adding another layer like a condom can only add to one’s safety, why not take every precaution, the stakes are high, especially when considering that the only reason we might take a less safe route is because it might not “feel” as good. i’m not sure why people dont ask women your questions…i was commenting on this topic here today.

May 10, 2015 at 12:05pm

Realityis

@courthousedoc: I respect your belief system. I really do. I don’t care what, or if, you believe in. Truly don’t. But why do you have to make fun of others belief systems? Do you really think the majority of people who believe in their religion don’t believe in progress or science? That really is unbelievable to me.

Also, science has been wrong on many occasions. I think science is great, but Science = Pharmaceutical Companies = Greed (regardless of whether the science is right or wrong. Big Phama is gonna make their money whether it’s ethical or not. I’m sure they knew about the lipodystrophy side effects prior to putting the meds on the market. Sure it’s given me a long life but it’s also given a less enjoyable life and does for many, many others who are dealing with the same things. Just go on the thebody.com and check the forums.

And clearly you are not using PrEP the way science had intended it to be used, which is written on Truvada’s website. TRUVADA is a prescription medicine used in 2 different ways: the second way is to help reduce the risk of getting HIV-1 infection when used together with safer sex practices.

Actually what you are promoting is putting people in harms way, when you promote your barebacking ways. All it takes is that first person to become positive while on PrEP.

AlexM123

I’m really surprised by how content gay people are with being whores. Gay people want to act like the HIV crisis is over just so they can have another excuse to not use a condom. In reality it’s worse than ever because everyone is ditching condoms in favor of using PrEP only. What the fuck is up with that? Learn to use a goddamn condom and STOP endangering yourselves and others. PrEP is not a miracle drug and people need to stop acting like it!

May 10, 2015 at 2:05pm

courthousedoc

@AlexM123: People like you need to stop acting like condoms are the gold standard and provide 100% protection. They don’t. The iPrEx OLE released at the 20th International AIDS Conference last year showed that taking PrEP 2-3 days a week provided 84% protection (which is better than condoms) and taking PrEP at least 4 days a week provided 100% protection. That’s what the study showed. Not sponsored by Gilead. Independent research by AIDS researcher. Internationally based. Whether you want to believe in science is up to you. But relying solely on condoms is what endangering people and the 50,000 cases of HIV a year, which is unchanged in decades proves it.

May 10, 2015 at 4:05pm

courthousedoc

@Shawn Laudun: And 20-30% of the time they don’t. Some of which is why we still have 50,000 cases of newly diagnosed HIV infections every year. Denying that condom failures are a significant part of that is sticking your head in the sand.

May 10, 2015 at 4:05pm

courthousedoc

@joey: Why not take every precaution? As others have pointed out, when you are my age, condoms make maintaining erections more difficult and quality of erections less. Many bottoms cannot tolerate them, no matter the quality or type of lube or condom used. And given the scientific studies (iPrEx OLE shows 100% effectiveness when taken 4 or times a week and I have NEVER missed a dose and I never will), I would gain nothing by doing so. Every precaution would be to not have sex in the first place, wouldn’t it? That isn’t acceptable. I’m using what I believe to be the optimal preventive method for my own protection. And so far, no one who has taken PrEP every day as directed has ever seroconverted.

May 10, 2015 at 4:05pm

joey

joey

@courthousedoc: to say no one has seroconverted you must be privy to some incredibly large statistics. i was infected 2 yrs ago with hep b and am currently on tenofovir, the active ingredient in truvada. the “Thialand study” and CDC state that tenofovir alone or with emtricitabine offers the same protection. i still would never just trust it alone nor have bb sex, thats just me i guess. after years of having a crazy wonderful sex life i finally began realizing how often i was lied too (and it seemed to be getting worse) i just stopped pushing my luck and having sex. i just decided its just not worth the constant worry and guess work as to who is lying to you about their status.. i cant worry about who is poz, who is on prep, who isnt on prep, if the condom broke etc etc..

May 10, 2015 at 5:05pm

joey

lauraspencer

I’m confused. I’ve been a lot of bottoms over the years and at no time has anyone of them ever said I can’t tolerate a condom. I guess I must be doing something right that they have come back for more even though I always where a condom.

So many guys on this thread are making it sound like wearing a condom is like having tin foil wrapped around their dicks. How are guys having sex that a condom affects the feeling so much that it isn’t enjoyable? Are your dicks covered in callouses that it can’t feel the friction even with a condom? Are the hole you are plowing so loose that there is no friction?

I just don’t buy the whole idea that a condom decreases the sensation so much that sex isn’t enjoyable or maybe I’m just having sex with more than just my penis….my brain, heart, etc.

May 10, 2015 at 6:05pm

courthousedoc

@lauraspencer: Then why do the majority of straight guys refuse to wear them either? And they do.

May 10, 2015 at 6:05pm

lauraspencer

When it comes to health I’m not making it a gay/straight issue, BUT statistically speaking you know gays are much more at risk than straights for HIV infection.

Someone who is diabetic has to be more aware of what they eat than someone who is not. You can’t live by the same rules for one group that is at risk and one that is not. I know it might seem “unfair” but that is life.

As for the pleasure issue I would also say the same thing about straight men who say they can’t enjoy sex with a condom. If they aren’t getting pleasure by wearing a condom I would question what they are doing wrong.

I am basically blind as a bat. I wish I didn’t have to wear glasses, but I do. I’m not envious of people that don’t wear corrective lenses. That is just life.

May 10, 2015 at 7:05pm

notevenwrong

@lauraspencer: “If they aren’t getting pleasure by wearing a condom I would question what they are doing wrong.”

I don’t think it will get us anywhere to accuse tops or bottoms who don’t enjoy sex through a condom of just doing it wrong, or being too loose, or of having the cheek of wanting to have sex with their bodies as opposed to their minds. Not everyone is like you. Some of us, maybe most of us, feel a significant difference.

I suspect it is the opposite of what you say though – guys who don’t feel much difference probably are the ones who don’t have much sensitivity in the first place. For me the difference is dramatic – it’s like the difference between watching a movie in color and watching it in black and white. Sure, I can follow the movie in black and white, but do you really expect me to never see a color movie again until or unless I get “married”?

May 10, 2015 at 7:05pm

courthousedoc

@lauraspencer: Not everyone is the same. That’s like a straight man saying “I enjoy fucking women. Most men do. Why don’t you?” We all aren’t the same. And not all condoms are the same. Not even close. Some guys who need magnums aren’t using them. Some guys who use them shouldn’t. Regular thickness, ultrathin, bareskin, ribbed. Trojan, Durex. And then the lube makes a huge difference. Water based, silicone, simply ky jelly. It all makes a difference. So your experience isn’t universal. Hardly. And don’t even get into the factors of age and condoms.

May 10, 2015 at 7:05pm

SportGuy

If this new drug were being utilized the way it was intended, which is with condom use, then I would be all for it. However, since more gays are taking this as a way to bb, I feel this drug is going to do more harm. Flat out if a guy ask me to not use a condom because he is on prep, then I will be walking away from him, no questions asked, because more than likely he has bb with tons of others and I won’t put myself at risk because he wants to be wreckless.

May 10, 2015 at 8:05pm

electrongreen

Did someone say 5 hot men? Where? Why waste money on stupid people that refuse safe sex?
The money should be spent on those more deserving of health care, rather than those that court disease through selfish and stupid behaviour

May 10, 2015 at 8:05pm

courthousedoc

@electrongreen: What part of condoms aren’t safe sex, merely safer sex don’t you understand? What part of condoms having failure rates up to 30% don’t you understand? Which is why condom failure is certainly a considerable part of the 50,000 new cases of HIV infections every year. As we have had for many years. PrEP is safer than condoms, when taken every day. Independent studies prove it. What part of that dont you understand?

May 10, 2015 at 8:05pm

SportGuy

@electrongreen: Agreed! It is a waste of money to make this drug, just so guys can bb, that defeats the purpose of adding and extra layer of protection in addition to condom use if most guys aren’t using it properly, which they aren’t. They are just using it as an excuse to bb, which is very selfish and idiotic.

May 10, 2015 at 9:05pm

courthousedoc

@SportGuy: I’m just glad you’re content with 50,000 new cases of HIV infections every year, which is unchanged in years. What is the cost of that, in dollars and the human toll? Because relying only on condoms will never change that number. NEVER.

May 10, 2015 at 9:05pm

PrEPWarrior

So much judgment, condemnation. This makes me so sad. There are 50,000 new HIV infections a year in the US. Condoms are effective but, not effective enough. If PrEP came out in the 80’s or 90’s folks would be lining up for it.

Some folks use PrEP in tandem with condoms. Some use condoms along with PrEP if they’re hooking up. Some folks use only PrEP. At least they’re protecting themselves and the community from HIV. And, what the heck is wrong with maximizing pleasure? This is exactly what women went through when the birth control pill came out.

Heaven forbid you have satisfying sex, while protecting yourself. Sheesh

May 10, 2015 at 10:05pm

dggeelong

Most people [straights as well as same sex] are unaware that the next AIDS has been in existence since 1997.
It is also sexually transmitted, just as deadly, painful and debilitating. You will all know when it spreads – it will be soon after they announce they have a cure for AIDS.

PrEP will not stop all infections – the greatest prevention is for monogamous relationships that commence with testing and condoms for the first 3 months – this is NOT a guarantee either just minimizes the risks.
Monogamy excludes all group, casual and adulterous encounters.

Monogamy is for as long as you both maintain your commitment, if either of you withdraw your commitment then you can both move onto a new monogamous relationship.

For those who think their religion is telling them ‘truth’ – sorry they are nearly all lying – God fully blesses and enriches the above monogamous relationship equally for same sex and opposite sex couples!
Only the person sharing his or her deepest love according to their sexuality can know God’s love in their life!

There is only ONE sexuality in the world – IT IS BI-SEXUALITY!
Many Bisexuals predominately prefer opposite sexual loving relationships. While many Bisexuals prefer to share their love with somebody of the same sex.
The LARGEST NUMBER OF Bisexuals can have their needs for true love from a monogamous relationship with another person of either the same or opposite sex – never both at the same time!

May 10, 2015 at 10:05pm

PrEPWarrior

Did you know that most new HIV infections occur within primary relationships? Frequent testing is key. Know your status

May 10, 2015 at 11:05pm

Stache99

@jwtraveler: Hey don’t shoot the messenger. I know it’s not PC to talk about but I’m just talking reality. I’d be willing to bet that most PrEP users tossed the condoms. I mean what is the point of using it if you’re still using a condom? Does not compute. Is this akin to what we used to call “double bagging it”>

May 11, 2015 at 12:05pm

Stache99

@joey:Hey there joey. Still fighting the good fight whatever that is:-)

May 11, 2015 at 12:05pm

joey

@Stache99: whats your email? you want to trade a pic love to see what you look like? where do you live?

May 11, 2015 at 3:05pm

Blackceo

Take a pill I don’t need that could possibly give me damaging side effects that only protects against one STI when condoms, which have done the trick so far, has protected me from contracting anything? Naw I’ll pass. To each his own tho. If I was still single I would not be taking this. I have been fortunate to have to not shove a pill down my throat every day so I sure as hell wouldn’t do it voluntarily. In addition, no longitudinal studies on this drug so no. I will be sticking with condoms.

May 11, 2015 at 2:05pm

wpewen

Now I know how I feel: Guys who think they have to be getting it on all the time, meaning ass action with other men who are not their regular lovers, friends, or fuck buddies. Kind of gluttonous. Fun, but still…
At 56 I well remember our first solution as horny young men, now I’m a horny Daddy-J/O clubs were/are fine for getting your rocks off and getting some great visuals on other guys. I always found it crazy even before AIDS that guys wanted to do anal intercourse with everyone they met. You guys who are insisting on doing all this complicated stuff are expending a lot of energy on health issues you do not have to. Even if I was the young little buck I was at 24 I wouldn’t want to hump with you. Way too much work.

May 11, 2015 at 2:05pm

Eoak

From a science stand point I support this approach. However, these random articles in support or against are generally so poorly constructed in both their content and scope that it’s laughable.

There should be a ethical imperative to include side effects and to pointedly speak to who is, and should be thinking of using any type of prevention method.

This pre-exposure prophylaxis is good option for anyone who is engaging in high volume sex partners where little is know–without question a good thing.

It’s here:
“Although the analysis did not examine the factors driving the
increases in young MSM, other studies indicate that individual risk
behavior alone does not account for the disproportionate burden of
HIV among young MSM. Other factors are likely at work, including:
higher prevalence of HIV among MSM, which leads to a greater risk
of HIV exposure with each sexual encounter; the high proportion
of young MSM (especially young MSM of color) who are unaware of
their infection, which increases the risk of unknowingly transmitting
the virus to others; stigma and homophobia, which deter some from
seeking HIV prevention services; barriers, such as lack of insurance
and concerns about confidentiality, that result in less access to
testing, care, and antiretroviral treatment; and high rates of some
STDs, which can facilitate HIV transmission. Additionally, many young
MSM may underestimate their personal risk for HIV.”

I’ve been off-the-grid so to speak for a decade, yes. That doesn’t mean I’m always going to stay that way (I’m starting to date a little more, though that doesn’t mean one-night stands or increased sexual activity – yet, anyway). Anal sex isn’t my preferred thing, but I have done it before. HIV also isn’t solely transmitted through penetrative sex, though I admit that’s the most common sexual transmission method.

Frankly, I still like having air bags in my car even though I always wear my seat belt and try not to get into accidents. Having an additional level of protection isn’t a bad thing and makes me more comfortable – even if I plan to never need it. Add in that, for whatever reason, most of the guys I end up dating tend to fall into some of the high-risk-for-unknown-infection categories, and it simply makes sense to use whatever protection exists.

I hate – *hate* – taking pills. I don’t even like taking Advil. It’s not a “polluting my body” thing as someone else said but simply the act of doing it (oddly, I tend to gag, which isn’t a problem elsewhere). I spent months considering all of this, reading studies, etc., before I asked my doctor about it. But I’ve taken my PrEP every morning at 7 am for months now without missing a dose, even when I’ve been out camping or at someone’s place.

And as I said on my last post: this is just until something better comes along. There are a few vaccines in the pipeline that are promising, and who knows what else will be out in the next couple of years. But to me it’s worth it to have to endure swallowing a pill every morning and facing some potential but unknown side effects down the road than even the slight risk of an HIV infection. For me, the pill may mostly be a security blanket, but it *does* work, and I’m safer taking it.

Someone else mentioned having to “talk” Kaiser into supplying it; not sure of other regions, but Kaiser Permanente SoCal didn’t need any convincing at all. There’s a strict regimen and process you go through, but since PrEP is recommended by the CDC for MSM, there’s no argument.

May 11, 2015 at 4:05pm

PrEPWarrior

Define primary partner? Steady partner/boyfriend/girlfriend/spouse, in an open relationship

May 11, 2015 at 9:05pm

PrEPWarrior

Or, monogamous and status unknown

May 11, 2015 at 11:05pm

notevenwrong

“Sixty-eight percent of HIV transmissions were from main sex partners because of a higher number of sex acts with main partners, more frequent receptive roles in anal sex with main partners, and lower condom use during anal sex with main partners.”

The defined primary partners as “someone who you feel committed to above all others.” This doesn’t mean open relationships necessarily – it can also include monogamy, either long term or serial, with partners of unknown status, which is the rule rather than the exception – very few guys follow the “testing after three months before discarding condoms” advice.

May 12, 2015 at 8:05am

notevenwrong

Also consider that another study showed that about a third of guys in relationships broke monogamy agreements in the previous year and over half of these didn’t disclose the outside sexual contact to their partners.

@SportGuy: This “intended with condom use” nonsense – obviously no agency is going to advise “stop using condoms” but 5 out of 6 of us already do not use them consistently – ignores one thing: candidates were SELECTED for the PrEP studies based on their acknowledging high-risk behavior. So do you REALLY think that people STARTED using condoms 100% to be in a drug trial when they were selected for NOT using them consistently? Makes no sense.

May 12, 2015 at 10:05am

joey

i just dont understand what the big deal is with using a condom, i’ve never bb and with all the information you need to be an idiot to put your life on the line because its a quickie, someone ‘told you” he was neg, or my favorite reason to put yourself at risk for aids “it feels better” . “feels better” ?? damn… this “feeling” must be amazing to put yourself at risk for with a lifelong disease, expensive treatments and meds, continual doctor visits, side effects of meds for some,and the stigma around it all. DAMN what a feeling it must be!

May 12, 2015 at 11:05am

notevenwrong

@joey: “or my favorite reason to put yourself at risk for aids “it feels better” . “feels better” ?? damn… this “feeling” must be amazing to put yourself at risk for with a lifelong disease…”

Well, yes, it IS amazing. What is wrong with wanting sex that “feels better”? The point of PrEP is that you AREN’T putting yourself at risk.

May 12, 2015 at 2:05pm

joey

@notevenwrong: you know what else feels to good to lot of people, meth, cocaine, drugs, blowing through a red light…i could go on and on my point is you dont do dangerous things just because something happens to feel good. taking less than the available precautions is foolish. i agree that prep can add to one’s protection, but let’s not tempt fate by skipping the condom. using prep needs to be an ADDITION to safer sex not somethihng you take so you can lower your protection in another way, do BOTH

May 12, 2015 at 3:05pm

notevenwrong

@joey, gay sex is not comparable to doing drugs.

For my part, I am comfortable that the research shows that with PrEP I am at least as safe as using condoms, maybe even safer than condoms. Are you comfortable with using just condoms? I am as comfortable with using just PrEP.

May 12, 2015 at 4:05pm

Pete

First, we tend to get blindsided by HIV to all the other STIs out there, a few of which, like anal cancer secondary to HPV infection, are as deadly. Obviously Truvada doesn’t protect against that (a condom will). Personally I think all men, gay, straight, whatever, should get a Guardasil series, which at present is only indicated for tween girls.

That said, I don’t have a lot of patience for all the finger-wagging safe-sex ninnies who insist that those of us who occasionally indulge have some kind of a death-wish. Norman Mailer once said that ‘a condom takes 40% off a fuck’. I’d put the number at 50 for a top and >60 for the bottom.

I think that the exchange of that bodily fluid is more essential to out sexual experience than it is for heterosexuals, especially if they’re not looking to be in a family way. It’s the most purely erotic act I can imagine.

May 12, 2015 at 5:05pm

notevenwrong

@Pete, yes to Gardasil. A small clarification – as far as I know condoms are not considered protective against HPV, which by the way can also lead to oral cancers. I do wonder how many of the finger-waggers have bothered to get the HPV and Hepatitis vaccines.

And you bring up an important point with regard to the fluid exchange. For many of us this is one of the most erotic and intimate parts of sex. For some guys there isn’t much point to sex without it. Just like the reduction in sensation due to condoms cannot just be brushed off as unimportant, fluid exchange also can’t just be brushed off as unimportant. Most bottoms I have met love receiving cum, including me when I am in bottom mode. As soon as people dismiss this instinct, they are immediately losing a significant part of the safer sex audience.

May 12, 2015 at 7:05pm

joey

@notevenwrong: i am speaking only from my own experiences, i now have a life long disease (hep b not hiv) that was probably contracted from sex. i had the vaccine but probably too late. i now must go to the doctor every 6 months for the rest of my life, blood work, scans, ultra sounds and a pill every day forever (ironically the same pill that can be used in prep). two years later i still cant remember any sex i had that was worth this, since then i’ve been terrified to have sex i havent had any since then. i understand this is difficult for anyone to understand that has not gone through something like this..

May 12, 2015 at 8:05pm

notevenwrong

@joey, sorry to hear it. I lost a friend to complications from chronic Hep B back when it was not as treatable as now. He didn’t let it rule his life though, and still had a good sex life (including with me), and I hope you won’t let it rule your life either.

May 13, 2015 at 8:05am

Realityis

@notevenwrong:The makers of Truvada intend it to be used, for PrEP purposes, this way “to help reduce the risk of getting HIV-1 infection when used together with safer sex practices”. Here is the Miriam-Webster definition of safe sex practices.
“sexual activity and especially sexual intercourse in which various measures (as the use of latex condoms or the practice of monogamy) are taken to avoid disease (as AIDS) transmitted by sexual contact —called also safer sex”
So unless you are only having oral sex, then you are not using the pill the proper way.

I’ll say it again. Anyone who doesn’t promote PrEP with the use of other safe sex practices is using it incorrectly and is putting out potentially harmful information to a scared and questioning population.

It only takes one person to become infected in this method and then this all blows up. I see that day coming very soon if it hasn’t already happened.

May 13, 2015 at 2:05pm

notevenwrong

@Realityis, no health authority in the U.S. is going to tell people they don’t have to use condoms. It would be legal suicide, given our court system.

However, that 99%-plus protection is for PrEP used alone, WITHOUT condoms (the placebo-controlled studies are able to distinguish the effect of just PrEP separate from condom use).

In other words, PrEP *is* safer sex, when taken every day it is safer than condoms.

May 13, 2015 at 3:05pm

Realityis

@notevenwrong: Ahhhhh, so you have had in-house, closed door discussions with the makers of Truvada and they have personally told you that it’s ok to use without condoms, but they won’t tell the general population. Nice that you have that inside knowledge… now if you could only tell them not to be so fucking greedy and make the medication affordable or generic that would be great…. thanks….

I’m not a scientist so I don’t know anything about placebo controlled studies. All I know is the reality of what these medications have done to me physically and I cannot let people give bad advice to others who are vulnerable and may end up dealing with physical and psychological issues that I have. I don’t want to see 1 person become infected because they listened to advocates of bareback sex thinking they were covered by just taking the pill.

I have no problem if people who want to bareback and become HIV positive. That’s there choice. Unfortunately that was my choice 21 years ago, with a partner of 5 years, and I regret it to this day.

May 13, 2015 at 4:05pm

notevenwrong

@Realityis: “Nice that you have that inside knowledge… now if you could only tell them not to be so fucking greedy and make the medication affordable or generic that would be great…. thanks…. I’m not a scientist so I don’t know anything about placebo controlled studies.”

It is clear that you don’t. I don’t have inside knowledge, but I know about placebo-controlled studies and I have actually bothered to read the research. I am not saying anything that isn’t publicly available.

PrEP is affordable for most guys in the U.S., either because it is covered by most insurance policies, Medicaid, special state of city programs, or aid for uninsured and uunderinsured from the company who makes it. I agree that a generic for Truvada should be available as a matter of national interest – and a generic IS indeed available as we speak at a small fraction of the price, as a matter of national interest, in a number of other countries not ruled by corporations like the U.S.

May 13, 2015 at 7:05pm

Realityis

@notevenwrong: Starting to think I have gone back and forth with you but you had another name.
The fact that insurance is covering this drug so guys can go back to risky behavior boggles my mind. But they won’t cover my facial injections and liposuction. So I have to live with this because I make too much money but not enuf to keep having these procedures. Talk about selfishness.

This is going to soooo blow up in everyones face and you aren’t helping anyone with these facts and figures you keep putting out there, because as soon as people start testing positive, those facts and figures are going to be s**t.

I want to scare people. I don’t want this disease on this earth. I want it to die with me. I HATE, HATE, HATE this disease and people who condone barebacking, unless with absolutely monogamous partners who both have tested negative for 3 years, need to go on a secluded island and wipe each other out.

May 13, 2015 at 10:05pm

PrEPWarrior

@Realityis: I’m so sorry your having a rough time. I do wish insurance covered the procedures you need. It’s wrong that they don’t!

Truvada as PrEP CAN help us decrease HIV infections. That’s the goal we’re all looking to achieve. We’re all in this together.

The us and them PrEP versus condom camps sadden me. Everyone has a right to choose the HIV prevention that works best for them. Be it condoms only, PrEP only, both together, whatever works!

I’m happy we have an additional tool in the arsenol. It’s about time. Condoms work, PrEP works. I look forward to more choices for all that will help bring new HIV infections down. It’s about time

May 14, 2015 at 12:05am

Realityis

@PrEPWarrior: I’d rather you wish for the cure to come out and not more things that “might or might not work” or “maybe cause this side effect or that”. This is the problem. Big Pharma will milk this disease for all they can. Cure does not translate to profit so there is no incentive to bring it out yet. We all know it’s out there.

Regarding my rough time, don’t worry about me. I have learned to live with it. I still work and make money. I still go out and play sports. I just don’t do these things with the same amount of anticipation or joy and my outgoing personality has surely dwindled. I’m sorry that you are condoning acts that can cause a lifetime of unpleasantness for others. I almost equate you to the wrestler who is in the news right now for lying about his HIV status. PrEP is supposed to be used along with other safer sex practices. It’s right there in black and white. No study can possibly provide every result there is.

To everyone out there….. You don’t want HIV. You really don’t.

May 14, 2015 at 7:05am

notevenwrong

@Realityis, I’m sorry about your lipodystrophy, and I agree that your procedures should be covered by insurance.

But the facts are that if you condemn barebacking with PrEP then you should especially condemn using just condoms, since condoms are less protective than PrEP.

May 14, 2015 at 6:05pm

notevenwrong

@Realityis, or even, why don’t you encourage using condoms WITH PrEP then, if you don’t want people to get HIV? The estimates are that condoms alone are only about 90% effective in the best case scenario.

As for lipodystrophy, you know more about it than I do, but I assume it doesn’t suddenly happen overnight. PrEP can be stopped at any time if someone should notice even the slightest sign of onset of this or any other side effect.

I agree with you that Big Ph&rma are basically like war profiteers, getting rich on our backs. That won’t change unless and until there is a revolution in the United States, though. I kinda wish there would be.

May 14, 2015 at 7:05pm

Realityis

@notevenwrong: How many names do you writer under?
No Lipodystrophy doesn’t happen overnight but it also doesn’t stop just because you stop the medication. They didn’t tell you that now did they. The medication damages the mitochondria in the cells.

I don’t care one way or another who barebacks or who doesn’t. Sex is great either way. All I want is for people to stop proclaiming that other safer sex practices aren’t needed just cus you take a pill. Truvada makers say it’s needed. So advising other people that they don’t need to take those other precautions is reckless. And it’s not even correct according to the makers of the medication. What is so hard to understand about that?

I’m 50 years old and hope that I am around to see the cure come out, and I plan on living another 30 years. If I don’t see a cure in those 30 years, I’ll know why.

You morons are the ones that fuel this nonsense. So many want a magic pill, instead of behaving like adults. Instead they settle for acting like self-loathing morons, and when the shit hits the fan and they are victims of genocide, they still can’t figure it out

Columbus

This is the one of the most irresponsible public health campaigns that I have ever seen.

I have been on Truvada since it was an investigational drug and the side effects are real.
If that quote by Dr. Montaigner is true, then I certainly agree. Bone loss is accelerated by long term of this drug and that has been I can confirm that by my own use of the drug. I so cannot wait until the Personal Injury attorneys start advertising for clients and they will find many.

PrEP was just rolled out here in Columbus and the announcement was irresponsible. Columbus like many urban areas are in the middle of the biggest Syphilis outbreak in history and yet they push this crap without ANY discussion of condoms. ZERO ZIPPO ZILCH. https://www.youtube.com/watch?v=w6MCi_aoK3I Not only that, a doctor within that press conference had privately admitted in an email that they didn’t mention condoms on purpose just to get them into the clinic. in the context of a syphillis outbreak, how many more people will get infected before some of those folks get tested and treated.

As for the Truvada Whore term, ( who was coined by a pro PrEP individual) that is highly insulting to individuals who have to take this crap to live. They do not give a damn about that and are only worried about their own selves.

May 17, 2015 at 5:05pm

AlexM123

After reading all of your posts, I seriously hope that you get HIV and die from it. You are really going to say that because of the fact that condoms are not 100% effective, we shouldn’t use them? Gay people like you make me sick. Here’s your logic right back at you: PrEP is not 100% effective, so people shouldn’t take it ever.

You are delusional. There are over 50,000 new cases of HIV every year specifically BECAUSE people refuse to use condoms or don’t use them properly. How little value does your life have that you would rather risk it than put on a condom? And what about other STD’s? Prep only protects against HIV. Should everyone just roll the dice all the time and have bareback sex because “condoms don’t work all the time?”

Seriously you are one low-life man.

May 17, 2015 at 9:05pm

PrEPWarrior

Oh please, condoms aren’t a 100% effective either.PrEP is ideal for folks that admit they don’t use condoms. PrEP alone is better than not using anything. Condoms only, PrEP only. At least folks are choosing some form of protection to prevent HIV.